Wolters P L, Brouwers P, Moss H A, Pizzo P A
Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Pediatrics. 1995 Jan;95(1):112-9.
To investigate the effect of HIV disease on the receptive and expressive language of children and the relationship between CT scan brain abnormalities and language functioning.
Thirty-six children (mean age, 5.5 years; range, 1 through 10 years; 75% vertical transmission; 58% classified as encephalopathic) with symptomatic HIV infection and 20 uninfected siblings (mean age, 7.8 years; range, 3 through 15 years) were administered an age-appropriate comprehensive language test assessing both receptive and expressive language (Reynell Developmental Language Scales or Clinical Evaluation of Language Fundamentals--Revised). Each HIV-infected child had a CT scan of the brain as part of the baseline evaluation, which was rated independently and blindly by two neurologists, for presence and severity of brain abnormalities using a semiquantitative rating system.
Expressive language was significantly more impaired than receptive language in the overall sample of HIV-infected children. The encephalopathic children scored significantly lower than the non-encephalopathic children, however, the degree of discrepancy between mean receptive and expressive language scores was not significantly different between these two groups. The uninfected sibling control group did not have a significant discrepancy between receptive and expressive language, and they scored significantly higher than the infected patient group. Greater severity of CT scan abnormalities was significantly correlated with poorer receptive and expressive language functioning in the overall HIV-infected sample and a higher discrepancy between receptive and expressive language in the encephalopathic group.
Pediatric HIV disease is associated with differential receptive and expressive language functioning in which expressive language is significantly more impaired than receptive language. The sibling data and CT scan correlations suggest that the observed language impairments are associated with the direct effects of HIV-related central nervous system disease.
研究人类免疫缺陷病毒（HIV）疾病对儿童接受性语言和表达性语言的影响，以及脑部CT扫描异常与语言功能之间的关系。
对36名有症状的HIV感染儿童（平均年龄5.5岁；范围1至10岁；75%为垂直传播；58%被归类为脑病型）和20名未感染的同胞（平均年龄7.8岁；范围3至15岁）进行了一项适合年龄的综合语言测试，评估接受性语言和表达性语言（雷诺尔发育性语言量表或语言基本能力临床评估修订版）。作为基线评估的一部分，每个感染HIV的儿童都进行了脑部CT扫描，由两名神经科医生独立且盲法对脑部异常的存在和严重程度使用半定量评分系统进行评级。
在感染HIV的儿童总体样本中，表达性语言比接受性语言受损更明显。脑病型儿童的得分显著低于非脑病型儿童，然而，这两组之间平均接受性语言和表达性语言得分的差异程度没有显著差异。未感染的同胞对照组在接受性语言和表达性语言之间没有显著差异，且他们的得分显著高于感染患者组。在整个感染HIV的样本中，CT扫描异常的严重程度越高，接受性和表达性语言功能越差，在脑病型组中接受性语言和表达性语言之间的差异越大。
儿童HIV疾病与接受性和表达性语言功能的差异有关，其中表达性语言比接受性语言受损更明显。同胞数据和CT扫描的相关性表明，观察到的语言障碍与HIV相关中枢神经系统疾病的直接影响有关。
